不同剂量右美托咪定复合左布比卡因用于臂丛神经阻滞的效果比较  

Effect comparison of dexmedetomidine combined with levobupivacaine in brachial plexus block

作　　者：刘绍正 王先锋[1] 李雷[1] 李伟[1] 蒲新[1] 陈海涛[1] LIU Shaozheng;WANG Xianfeng;LI Lei;LI Wei;PU Xin;CHEN Haitao(Department of Anesthesiology,Wanbei Coal-electricity Group General Hospital,Suzhou Anhui 234000,China)

机构地区：[1]皖北煤电集团总医院麻醉科,安徽宿州234000

出　　处：《临床与病理杂志》2020年第10期2617-2621,共5页Journal of Clinical and Pathological Research

摘　　要：目的:比较不同剂量右美托咪定(dexmedetomidine)复合左布比卡因用于超声引导下臂丛神经阻滞患者的效果及安全性。方法:选择行上肢手术的ASA I~Ⅱ级患者120例,按照随机数字表法分为4组,即对照组(NS组)和右美托咪定D1组、D2组、D3组,每组30例,均在超声引导下行臂丛神经阻滞,注入0.375%左布比卡因30 mL。其中,NS组和右美托咪定D1组、D2组、D3组分别复合2 mL生理盐水和右美托咪定50,100,150μg。观察4组患者痛觉和运动阻滞维持时间、镇痛时间、血流动力学变化和镇静评分状况。结果:随着右美托咪定剂量的增加,痛觉、运动阻滞维持时间及镇痛时间显著延长(P<0.01),镇静深度也随之加深(P<0.05)。结论:右美托咪定复合左布比卡因产生剂量依赖性痛觉、运动阻滞延长和临床相关的镇静程度加深,右美托咪定100μg效果可靠且安全。Objective: To compare the efficacy and safety of dexmedetomidine(DEX) combined with levobupivacaine for ultrasound-guided brachial plexus block. Methods: A total of 120 patients with upper extremity surgery of the ASA I–Ⅱ level were enrolled and divided into 4 groups according to random number table method, namely a control group(NS) and 3 dexmedetomidine(D1, D2, D3) groups, 30 cases in each group, both in downlink brachial plexus nerve block guided by ultrasound, injecting 0.375% left than paid 30 mL. Among them, the control group(NS) and dexmedetomidine D1 group, D2 group, D3 group were compounded with 2 mL normal saline and dexmedetomidine 50, 100, 150 μg, respectively. The pain sensation and motor block maintenance time, analgesia time, hemodynamic changes and sedation score were observed. Results: With the increase of dexmedetomidine dose, the duration of pain, motion block and analgesia were significantly prolonged(P<0.01), and the depth of sedation was also deepened(P<0.05). Conclusion: Dexmedetomidine combined with levobupivacaine can produce dose-dependent pain, prolonged motion block and clinically related sedation. Dexmedetomidine with 100 μg has a reliable and safe effect.

关 键 词：右美托咪定 左布比卡因 臂丛神经阻滞 

分 类 号：R614[医药卫生—麻醉学]